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Quote request

So that we can provide you with the best possible terms the market offers, please answer the following questions as carefully and as precise as you can. The most important questions are those relating to licences and flying hours.

The fields provided with * are optional and do not have not to be filled out.

General Details
* Surame: * Name:
* Street: * No.:
* Post Code: * Town/City:
   Telephone:    Telefax:
* e-mail:
Are you already our customer?: noyes, my customer number is:

General Aircraft Details
* Aircraft type: Registration:
Date of manufacture: Serial number:
Max. Take-off weight: kg
Number of Pilot seats:
Number of Passenger seats:

1. Third Party Liability Insurance
Required Limit: yesno, i wish following limit: EUR 

2. Passenger Liability Insurance
Sums covered per Passenger: EUR 600.000;-- injuries to passenger                       
  EUR 1.700;-- baggage damage  yes  no

3. CSL (Combined Single Limit) combination of 1. and 2.
Required Limit: EUR

4. Hull Insurance
Aircraft value EUR:
incl. instruments, special equipmentyes no          incl. value added taxyes no
 
Aircraft use: (A) private, pleasure:
 
- 1 named pilot
- up to 3 named pilots
- up to 5 named pilots
- open pilot warranty
(B) club uses:
  - open pilot warranty including rental:
yes no
(C) commercial use
(D) ab-initio training
(E) rental
(F) glider towing/banner towing

If up to 5 named pilots and private use, please also answer the following questions:
 
Where is the aircraft based?:
Are you the owner of the aircraft: yes no
Breach of warranty necessary ? yes no
Pilots:
Flying Hours
Name, Surname age Total on make and model
1. hrs. hrs.
2. hrs. hrs.
3. hrs. hrs.
4. hrs. hrs.
5. hrs. hrs.
hours flown in the last 12 months expected use in the next 12 months Licenzes Renewal date
1.
2.
3.
4.
5.
Losses in the last 5 years: yes no
If you answered yes, please provide details:

5. Personal Accident Insurance
no yes
Insured sum: for death:   EUR 
  for invalidity:   EUR
 

6. Avionic Insurance
For high valued avionics (from EUR 10.000 and higher) we can offer an advantageous electronics insurance. This insurance is often less expensive than hull insurance and the cover is more comprehensive.
Would you like an offer?noyes, Avionic value in EUR

7. Engine Breakdown Insurance
The hull insurance does not cover damage to the inner engine.
Would you like an offer?noyes, Engine type
The value of the engine will be calculated by ourselves on the basis of manufacturer prices.

Data protection: your details will only be used for this enquiry and will not be given to any other third party.


If you are interested in pilots personal accident insurance, loss of licence insurance etc., then please call
++49 (0) 231 927 1770.


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